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symptoms of acute tonsillitis, early symptoms and signs of acute tonsillitis

symptoms of acute tonsillitis, early symptoms and signs of acute tonsillitis

Symptoms of acute tonsillitis

Early symptoms: 1) Sore throat: It is the most common local symptom. At first, it is mostly unilateral pain, and then it can develop into bilateral pain. Pain can be aggravated when swallowing and coughing. Severe pain can cause dysphagia, even saliva retention and ambiguous speech. Pain can radiate to the ipsilateral ear. 2) Dyspnea: It is generally not heavy. It often occurs in children. Because children's airway is narrower than that of adults, the significantly enlarged tonsils can block the airway and affect children's sleep, which can be manifested as snoring or waking up while sleeping.

Late symptoms: 1) Soft palate dyskinesia: The swollen tonsil squeezes the soft palate, causing transient soft palate insufficiency, and also causing ambiguous speech. 2) Related symptoms caused by the spread of inflammation to adjacent organs: If inflammation spreads to the throat, it can cause symptoms such as foreign body sensation, hoarseness, sore throat, expectoration, weak vocalization and even loss of voice; Spreading to the nose can cause nasal congestion, running water-like nasal discharge or mucous pus nasal discharge, headache and other symptoms; Spread to nasopharynx, can affect Eustachian tube, appear ear tightness, tinnitus, earache and hearing loss.

Related symptoms: swallowing pain, aversion to cold, high fever, sore throat, tonsillar congestion, tonsillar inflammation and tonsillar hypertrophy

First, acute tonsillitis symptoms:

Symptoms are usually mild in adults and severe in children.

1. Systemic symptoms:

Acute follicular tonsillitis and acute crypt tonsillitis are more serious. It is characterized by acute onset, accompanied by chills and high fever, and the highest body temperature can reach 39 ~ 40 ℃, which can last for 3 ~ 5 days. Children can vomit, twitch and lethargy due to high fever. Some patients may have headache, loss of appetite, general fatigue, constipation, back and limb pain and other symptoms. The manifestations of systemic symptoms are not specific.

2. Local symptoms:

1) Sore throat:

It is the most common local symptom. At first, it is mostly unilateral pain, and then it can develop into bilateral pain. Pain can be aggravated when swallowing and coughing. Severe pain can cause dysphagia, even saliva retention and ambiguous speech. Pain can radiate to the ipsilateral ear.

2) Dyspnea:

It's usually not heavy. It often occurs in children. Because children's airway is narrower than that of adults, significantly enlarged tonsils can block the airway and affect children's sleep, which can be manifested as snoring or waking up while sleeping.

3) Soft palate dyskinesia:

The swollen tonsil squeezes the soft palate, causing transient soft palate insufficiency and ambiguous speech.

4) Related symptoms caused by the spread of inflammation to adjacent organs:

If inflammation spreads to the throat, it can cause symptoms such as foreign body sensation, hoarseness, sore throat, expectoration, weak vocalization and even loss of voice; Spreading to the nose can cause nasal congestion, running water-like nasal discharge or mucous pus nasal discharge, headache and other symptoms; Spread to nasopharynx, can affect Eustachian tube, appear ear tightness, tinnitus, earache and hearing loss.

Second, physical signs:

1. Physical examination:

Acute appearance, flushing, high fever, unwillingness to speak and other symptoms. Mandibular angle and submandibular swollen smooth lymph nodes can be touched, with tenderness and good mobility. There may be obvious tenderness under both sides of the mandible. The elderly and children can be complicated with pneumonia because of poor resistance. At this time, pneumonia-related signs can be found in the lungs, such as dullness in percussion, unclear breathing sounds or rales.

2. Physical examination of otolaryngology specialty:

1) Pharynx:

Oropharyngeal mucosa is obviously congested and diffuse. Congestion of tonsils, pharyngopalatine arch and lingual palatine arch is more significant. Lymphatic follicles may proliferate in the posterior pharyngeal wall and bilateral lateral pharyngeal cords may proliferate. Children have obvious tonsillar enlargement, while adults' tonsillar enlargement can be manifested as enlargement or inconspicuous enlargement.

Acute catarrhal tonsillitis is characterized by hyperemia and swelling of tonsils without abnormal secretion on the surface. Acute follicular tonsillitis is characterized by hyperemia, swelling and suppuration of lymphoid follicles in tonsils, and yellowish-white protuberant pus spots can be seen on the surface of tonsils. Acute crypt tonsillitis can appear yellow-white pus at the mouth of tonsil crypt, sometimes it can fuse into pseudomembranous, which can be wiped away by throat swab without leaving bleeding wound.

The hypopharyngeal mucosa can also be slightly congested. When patients are afraid of swallowing due to pain, saliva retention can be seen in bilateral pyriform fossa. At this time, attention should be paid to observing the shape of epiglottis and being wary of acute epiglottitis caused by inflammation spreading to epiglottis.

There is no obvious abnormality in nasopharyngeal physical examination, and inflammation can cause mucosal congestion. Children may be accompanied by adenoid hypertrophy and congestion.

2) Larynx:

Usually not subject toTired. When inflammation spreads and causes acute laryngitis, bilateral vocal cords, ventricular zones, arytenoid mucosa and arytenoid epiglottic folds are symmetrically congested, which can be accompanied by mucosal edema of different degrees. However, bilateral vocal cord activity is generally unaffected.

3) Nose:

When complicated with acute upper respiratory tract infection or acute rhinitis, the nasal mucosa can show obvious congestion, with purulent nasal discharge in the early stage and purulent nasal discharge in the late stage.

4) Ear:

The tympanic membrane may show mild congestion due to acute inflammation. When combined with Eustachian tube dysfunction causes secretory otitis media, the tympanic membrane can be seen to be yellow and invaginated, and hearing can also be reduced. There is usually no abnormality in the examination of external ear and external auditory canal. Mastoid usually has no tenderness.

III. Diagnostic criteria:

According to typical medical history, signs and auxiliary examinations, the diagnosis of acute tonsillitis can be basically established.

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